Interview With Authors of Anxious Kids, Anxious Parents

After getting a press release about their new book, I did an e-mail interview with the authors of the book “Anxious Kids, Anxious Parents: 7 Ways to Stop the Worry Cycle and Raise Courageous & Independent Children”.

A quick bio on the authors Reid Wilson, PhD and Lynn Lyons, LICSW is below:

Reid Wilson, Ph.D. is the Clinical Associate Professor of Psychiatry at the University of North Carolina School of Medicine. He is author of Don’t Panic: Taking Control of Anxiety Attacks and the coauthor of Stop Obsessing! How to Overcome Your Obsessions and Compulsions.

Lynn Lyons, LICSW, is a licensed clinical social worker and psychotherapist in private practice and a sought-after speaker and consultant. She specializes in the treatment of anxiety disorders in adults and children, including generalized anxiety, phobias, social anxiety, obsessive compulsive disorder, and performance anxiety.

I didn’t get a chance to read the book, but from the teaser I received, I had a few questions which they answered for me.

What percentage of children have a diagnosable anxiety disorder today?

Research estimates that one in five children and adolescents have a diagnosable anxiety disorder. This does not mean that all of these children receive treatment, but that they have symptoms of anxiety that meet the criteria for an anxiety disorder.

How has the prevalence of anxiety increased over the years?

Although we don’t have exact data on the increase of anxiety disorders in children, we do know that research and understanding of anxiety in children has increased dramatically over the last two decades. More children are diagnosed based on a much greater knowledge and awareness of anxiety disorders such as Obsessive Compulsive Disorder and Post Traumatic Stress Disorder. Anecdotally, adults report greater stress levels, and we know that parental stress, anxiety and depression impacts childhood anxiety. Anxiety is the leading reason that a parent seeks out mental health treatment for a child, and most clinicians who work with anxious children are very busy these days!

Is there a test to know when someone is clinically anxious or just feels anxious? (i.e., when should parents seek help?)

First, it’s important to remember that anxiety is normal. It happens to all of us and is very helpful when dealing with danger. The warning system and fight-or-flight reaction is an important part of survival, so should be respected and appreciated. There is no “test” for an anxiety disorder. We look at the symptoms and functioning of a child to determine the diagnosis. Anxiety becomes a disorder when the child spends significant time managing the anxiety, or remains highly distressed due to their fear, or significantly limits their participation in normal life activities. For example, a family might expend a lot of energy making sure that a child doesn’t “freak out,” so the distress might be minimal, but only because everyone is working so hard to avoid any triggers. Or a child may be unable to manage daily events, such as going to school or friends’ houses, sleeping alone, or participating in new activities. Anxious children can also be very rigid, demanding that adults follow anxiety’s rules. When a child cannot handle changes in routine without great distress, and when a family feels that anxiety is in charge of the family’s functioning, then help is needed.

How does childhood anxiety show up in a kid’s behavior?

Avoidance is anxiety’s calling card. When a child consistently avoids, or becomes overly upset when avoidance isn’t possible, then anxiety is often the culprit. Other signs are when they become rigid about how things need to be done, when they have difficulty with new experiences or with uncertainty about how events are going to turn out, or when they begin skipping “fun” events because of fear or worry. Sometimes children are very good at expressing their fear, worries, or nervousness; again, this can be normal. If their worry prevents them from moving forward, and they tend to cry, throw a tantrum, or ask for excessive reassurance, then anxiety is probably in charge.

One great thing about being in the anxiety business is that it is a very treatable problem. Once you know how it functions, it’s not all that mysterious. Therapy is highly effective when it focuses on teaching children and parents how anxiety operates and then gives them concrete skills to handle anxiety’s predictable tricks. We work with parents and children together to make sure that patterns of avoidance and overprotection are interrupted, and we give kids concrete strategies to deal with anxiety when it shows up. Therapy should be active and experiential, meaning that families should have homework assignments that give them the experience of moving into uncertainty and then handling it.

Medication can help, but, if given the opportunity, we’d rather work with a family on learning new strategies first. Most kids and parents benefit greatly from psycho-education and skills. Even when medication is used, we don’t recommend it as the only course of treatment for children and teens.

What are the other impacts of childhood anxiety as someone grows older?

Anxiety in childhood is a very strong predictor of both anxiety and depression in later life. The more episodes of anxiety a teen has, the less likely they are to complete college. Most adults with anxiety report that they began having symptoms as a child, so we know that anxiety just doesn’t go away in children if left untreated; it actually gets stronger and leads to other diagnoses and problems. As you can imagine, if avoidance is your best coping strategy, you miss out on many experiences in life. Anxiety impacts relationships, career, and the ability to live independently. Risk of substance abuse is also increased as anxious teens and young adults self-medicate their symptoms.

What will the book teach parents and/or kids that will help them improve their level of anxiety?

Our book focuses on the importance of teaching children and teens how to handle uncertainty and discomfort. We normalize anxiety as a part of growing and developing, and we give parents concrete ways to support moving toward anxiety, rather than avoiding it. We help parents to understand that keeping their anxious child safe and comfortable actually makes anxiety stronger. We offer them a step-by-step plan to deal with anxiety when it (inevitably) shows up. Research tells us that anxious parents tend to have anxious kids. Our goal is to interrupt the transmission of anxiety from one generation to the next by helping parents react differently to their children’s worry and their own. And, actually, the skills we teach are preventative: handling uncertainty, being a problem solver, and knowing how to talk back to worry and move forward into life’s challenges are skills that all children should learn.